Treatment of severe fractures of the calcaneus by reconstruction arthrodesis using the Vira^® System: Prospective study of the first 37 cases with over 1 year follow-up

Abstract 

Purpose

To study the surgical applicability and clinical results of the Vira^® System in treatment for severe fractures of the calcaneus.

Methods

A total of 37 acute intra-articular fractures of the calcaneus treated by reconstruction and primary fusion with the minimally invasive Vira^® System. Of them, 33 patients were analysed over a 2-year period. All fractures were classified, according to the Sanders criteria, as grade IV. The mean age was 42.08 years. Four were bilateral fractures and three were open fractures. All the patients were evaluated, in a prospective manner, using the American Orthopaedic Foot and Ankle Society (AOFAS) scale, plain radiographs and CT scan studies.

Results

The average AOFAS score 12 months after surgery was 75.43 points (SD: 13.9). In 31 cases, the result was considered good and very good, and in five and one case mild and poor. Most of the patients (81%) could wear normal shoes; the footprint and the alignment of the heel were considered normal in all cases but seven patients showed a mild valgus deviation. The Böhler angle improvement after surgery was significant (p=0.05) and it did not vary along the follow-up. Subtalar arthrodesis was achieved in all cases. Only one case needed bone grafting. Important post-surgical complications were not registered in this cohort.

Conclusions

The Vira^® System is a useful option for the surgical treatment of severe fractures of the calcaneus, yielding good clinical and radiological results with a surgical procedure that is only minimally aggressive and has a low rate of complications.

Keywords: Fracture of the calcaneus, Surgical treatment, Subtalar fusion, Internal fixation